Basic Information
| Provider Information | |||||||||
| NPI: | 1366195836 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUTTON | ||||||||
| FirstName: | APRIL | ||||||||
| MiddleName: | DAWN | ||||||||
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| OtherLastName: | DUTTON | ||||||||
| OtherFirstName: | APRIL | ||||||||
| OtherMiddleName: | DAWN | ||||||||
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| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 65 BAILEY LN | ||||||||
| Address2: | |||||||||
| City: | CAPON BRIDGE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 267119045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043591141 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 500 PEGASUS CT | ||||||||
| Address2: | |||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226024596 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5403134196 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2022 | ||||||||
| LastUpdateDate: | 02/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.